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  • JAMA Ophthalmology June 1, 2017

    Figure 2: A Young Woman With Headaches and Blurry Vision

    Late-phase frame of fluorescein angiography showing dye leakage from choroidal neovascularization.
  • Economic Evaluation of a Home-Based Age-Related Macular Degeneration Monitoring System

    Abstract Full Text
    JAMA Ophthalmol. 2017; 135(5):452-459. doi: 10.1001/jamaophthalmol.2017.0255

    This economic analysis evaluates a home-based daily visual field monitoring system using simulation methods and applies the findings of the Home Monitoring of the Eye study to the US population at high risk for wet-form age-related macular degeneration.

  • The Potential Importance of Detection of Neovascular Age-Related Macular Degeneration When Visual Acuity Is Relatively Good

    Abstract Full Text
    JAMA Ophthalmol. 2017; 135(3):268-273. doi: 10.1001/jamaophthalmol.2016.5314

    This Special Communication reviews early detection and management of neovascular age-related macular degeneration to improve visual acuity outcomes.

  • Histopathological Insights Into Choroidal Vascular Loss in Clinically Documented Cases of Age-Related Macular Degeneration

    Abstract Full Text
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    JAMA Ophthalmol. 2016; 134(11):1272-1280. doi: 10.1001/jamaophthalmol.2016.3519

    This cross-sectional study examines histopathologic changes in the choriocapillaris of eyes with clinically documented age-related macular degeneration.

  • Early Insight Into Neovascular Age-Related Macular Degeneration

    Abstract Full Text
    JAMA Ophthalmol. 2016; 134(11):1281-1282. doi: 10.1001/jamaophthalmol.2016.3031
  • JAMA Ophthalmology November 1, 2016

    Figure 5: Grade 5, Patient 23, Left Eye

    Infrared and spectral-domain optical coherence tomography (OCT) images (A and B), a fluorescein angiogram (C), and Ulex europaeus agglutinin (UEA) lectin-stained choroid (D-G) from an 84-year-old white man with a history of neovascular disease treated with 6 anti–vascular endothelial growth factor injections. The infrared and OCT images (A and B) show drusen (including reticular-type drusen), retinal pigment epithelial (RPE) detachment, and early atrophic changes. The fluorescein angiogram prior to treatment displays the active choroidal neovascularization (CNV) (C). Low-magnification confocal micrograph of the UEA choroidal flat mount shows a CNV formation (black arrowheads) in the submacula, which was 5.8 mm2 (D and E). Choriocapillaris attenuation extended well beyond the edge of the CNV (white arrowheads in D). Higher-magnification micrograph (F) shows edge of CNV (area in box “f” in D) with looped hypercellular tips of neovascular vessels and capillary dropout adjacent to the edge of the CNV (asterisk). Peripheral to the CNV (G), the choriocapillaris has normal morphology. Scale bars: D = 1 mm, E = 500 μm, F and G = 250 μm.
  • JAMA Ophthalmology November 1, 2016

    Figure 3: Grade 3, Patient 13, Left Eye

    Infrared image (A) and spectral-domain optical coherence tomography (OCT) (B) obtained 3 months prior to death, and Ulex europaeus agglutinin (UEA) lectin-stained choroidal flat mount preparation (C-G) from a 93-year-old white man with a history of intermediate AMD (grade 3). The infrared image shows numerous drusen in the posterior pole with some apparent pigmentary abnormalities (A) in the macula and large drusen (arrowhead) on OCT (B). Low-magnification confocal micrograph of the UEA choroidal flat mount (C) shows reduced choriocapillaris density throughout submacula. The long arrow is an approximation of the position of the green scan line in A. Higher-magnification micrograph (D) of the region indicated by box in C shows loss of interconnecting capillary channels and a vascular malformation (arrowhead) that corresponds to the region indicated by the arrow in the OCT. High-magnification Z-series (E-G) of the vascular formation shown in D demonstrates that it is internal to the choriocapillaris and represents a form of choroidal neovascularization. It has multiple connections to the underlying choroidal vasculature (arrowheads in G). Scale bars: A-C = 1 mm, D-F = 100 μm.
  • Single-Nucleotide Polymorphisms Associated With Age-Related Macular Degeneration and Lesion Phenotypes in the Comparison of Age-Related Macular Degeneration Treatments Trials

    Abstract Full Text
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    JAMA Ophthalmol. 2016; 134(6):674-681. doi: 10.1001/jamaophthalmol.2016.0669

    This study evaluates the influence of genotype of single-nucleotide polymorphisms previously associated with age-related macular degeneration on the phenotype of neovascular lesions.

  • JAMA Ophthalmology May 1, 2016

    Figure 3: Choroidal Neovascularization in Patient 1 With Stargardt Disease

    A small subretinal hemorrhage was present (A; black arrowhead) and associated with a fibrovascular pigment epithelium detachment on optical coherence tomography (B; asterisk) and overlying cystoid macular edema (B; white arrowhead). Edema was resolved after 7 bevacizumab injections (C). Dashed line indicates position of optical coherence tomographic image (A).
  • Phenotypic Variation in a Family With Pseudodominant Stargardt Disease

    Abstract Full Text
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    JAMA Ophthalmol. 2016; 134(5):580-583. doi: 10.1001/jamaophthalmol.2015.5471

    This case series explores the clinical courses and genotypes of a woman and her 2 daughters with pseudodominant transmission of Stargardt disease.

  • JAMA Ophthalmology May 1, 2016

    Figure 3: Anatomical Responses Over Time in 15-Letter Responders

    All treatment groups are pooled. Observed data and ±2 SEMs (central foveal thickness [CFT], total choroidal neovascularization [CNV] area, total lesion area) or 95% CIs (error bars) (patients with presence of blood) are shown. DA indicates disc area.
  • JAMA Ophthalmology April 1, 2016

    Figure 2: Common Cytokine Signature in a Vitreous Sample From a Patient With Idiopathic Inflammatory Eye Disease

    A, Unbiased hierarchal clustering revealed the idiopathic inflammatory case (patient 9) clustered with cases of autoimmune retinopathy (P < .01). Orange indicates high expression; black to green, low expression, with black representing the lowest. B, Each uveitis type expressed unique protein profiles (described in eFigure 2 in the Supplement) and uveitis with a common cytokine signature consisting of upregulated interleukin 23 (IL-23), IL-1 receptor I (IL-1RI), IL-17R, tissue inhibitors of metalloproteinase 1 and 2 (TIMP-1 and TIMP-2), insulinlike growth factor–binding protein 2 (IGFBP-2), nerve growth factor (b-NGF), platelet-derived growth factor receptor β polypeptide (PDGFRb), bone morphogenic protein 4 (BMP-4), and stem cell factor (SCF) and downregulated vascular endothelial growth factor C (VEGF-C) and neutrophil-activating protein 2 (NAP-2). C, Hierarchal clustering of differentially expressed proteins (P < .01) show an unmistakable cytokine signature in the idiopathic case and autoimmune retinopathy cases. AIR indicates autoimmune retinopathy; ALCAM, activated leukocyte cell adhesion molecule; AR, androgen receptor; ARN, acute retinal necrosis; 4-1BB, tumor necrosis factor receptor superfamily member 9 (TNFRSF9); BLC, B lymphocyte chemoattractant; BTC, betacellulin; CNV, choroidal neovascularization; CTACK, cutaneous T-cell–attracting chemokine; EGF R, endothelial growth factor receptor; ENA-78, epithelial neutrophil-activating peptide 78; EpCAM, epithelial cell adhesion molecule; FasL, Fas ligand; FcrRIIB/C, fragment crystalizable receptor II; FGF-7, fibroblast growth factor 7; GCP-2, granulocyte chemotactic peptide-2; HCC-1, hemofiltrate CC-chemokine-1; ICAM-3, intracellular adhesion molecule 3; IGF-1, insulinlike growth factor 1; MCF R, mitochondrial substrate carrier family protein; MCP-1, monocyte chemoattractant protein 1; MICA, major HLA-A; MIF, migration inhibitory factor; MIP-1d, macrophage inflammatory protein 1d; MPIF-1, myeloid progenitor inhibitory factor 1; MRC, macrophage mannose receptor 1; NrCAM, neuronal cell adhesion molecule; NRG1-b1, neuregulin-1; PAI-I, plasminogen activator inhibitor I; PARC, C-C motif chemokine 18; PIGF, placental growth factor; TECK, thymus expressed chemokine; TGF-b2, transforming growth factor β2; TIM-1, T-cell Ig mucin I; TNFR1, tumor necrosis factor receptor 1; and TREM-1, triggering receptor expressed on myeloid cells 1.
  • Direct Visualization of a New Choroidal Vessel on Spectral-Domain Optical Coherence Tomography

    Abstract Full Text
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    JAMA Ophthalmol. 2016; 134(3):e155017. doi: 10.1001/jamaophthalmol.2015.5017

    This Ophthalmic Image shows a new choroidal vessel on spectral-domain optical coherence tomography in a man in his 60s.

  • JAMA Ophthalmology March 1, 2016

    Figure 1: Pedigrees of 5 Families With Age-Related Macular Degeneration

    Pedigrees depict results of segregation analysis of rare and common CFH Tyr402His and ARMS2 Ala69Ser variants in patients with the rare CFI Gly119Arg, C9 Pro167Ser, or C3 Lys155Gln variants of complement factor genes. Risk alleles are indicated in red. Affected individuals are assigned grades representing AMD stage (1 indicates early; 2, intermediate; 3, advanced with subfoveal geographic atrophy; and 4, advanced with choroidal neovascularization). Outer circles mark the individuals who underwent whole-exome sequencing.
  • JAMA Ophthalmology March 1, 2016

    Figure 2: Histopathological Findings

    A, Diffuse granulomatous inflammation of the choroid (bar = 100 µm) extended focally into choriocapillaris (inset; bar = 10 µm). B, Loss of choroidal melanocytes (surrounding the asterisk) corresponding to “sunset glow” in Figure 1E (bar = 200 µm). C, Peripapillary subretinal fibrosis and choroidal neovascularization corresponding to optical coherence tomographic image in Figure 1F (bar = 100 µm). D, Dalen-Fuchs nodule (focal aggregate of epithelioid histiocytes admixed with retinal pigment epithelial cells between the Bruch membrane and the retinal pigment epithelium; bar = 25 µm). All slides stained with hematoxylin-eosin.
  • Correlation of 3-Dimensionally Quantified Intraretinal and Subretinal Fluid With Visual Acuity in Neovascular Age-Related Macular Degeneration

    Abstract Full Text
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    JAMA Ophthalmol. 2016; 134(2):182-190. doi: 10.1001/jamaophthalmol.2015.4948

    This cohort study examines the correlations between intraretinal cystoid fluid and subretinal fluid parameters and visual acuity in patients with neovascular age-related macular degeneration.

  • JAMA Ophthalmology February 1, 2016

    Figure: Enrollment Data of All Reviewed Eyes

    DME indicates diabetic macular edema; OCT, optical coherence tomography.aConcurrent conditions included choroidal neovascularization, retinal vein occlusion, postsurgical macular edema, central serous retinopathy, macular retinal detachment, and epiretinal membrane or vitreomacular traction within 1 disc diameter of the fovea as determined on OCT.bTen of the eyes with ungradable-quality fundus photographs also had ungradable OCT images.cReasons eyes had ungradable OCT images included 3 scans with extreme decentration errors, 10 scans with poor signal strength, and 2 scans with dense preretinal hemorrhage shadowing and obscuring identification of the internal limiting membrane.
  • Qualifying to Use a Home Monitoring Device for Detection of Neovascular Age-Related Macular Degeneration

    Abstract Full Text
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    JAMA Ophthalmol. 2015; 133(12):1425-1430. doi: 10.1001/jamaophthalmol.2015.3684

    This study evaluates the utility of a qualification test to determine whether patients with high-risk age-related macular degeneration will be able to use a home monitoring device.

  • Optical Coherence Tomographic Angiography of Choroidal Neovascularization Associated With Central Serous Chorioretinopathy

    Abstract Full Text
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    JAMA Ophthalmol. 2015; 133(10):1212-1214. doi: 10.1001/jamaophthalmol.2015.2126

    This case report describes the use of optical coherence tomographic angiography to detect choroidal neovascularization.

  • JAMA Ophthalmology October 1, 2015

    Figure 1: Detection of Choroidal Neovascularization Associated With Chronic Central Serous Chorioretinopathy by Optical Coherence Tomographic (OCT) Angiography

    A-C, Color fundus photograph (A), midphase fluorescein angiogram (FA) (B), and midphase indocyanine green angiogram (ICGA) (C) of central serous chorioretinopathy (box). D-F, Optical coherence tomographic angiograms of retinal vessels (purple) and choroidal neovascularization (yellow) presented en face (D) and with structural OCT at sections noted in panel D (E and F). E, Circle indicates the focal choriocapillaris defect.